tag:blogger.com,1999:blog-75950602089651623312024-02-20T17:16:05.989-08:00Tyler's HeartRobert Denver TChttp://www.blogger.com/profile/14145497055665256073noreply@blogger.comBlogger56125tag:blogger.com,1999:blog-7595060208965162331.post-65829056382547227022011-09-30T11:47:00.000-07:002011-09-30T11:50:09.465-07:00A Reprieve9/30/2011<br />
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Tyler had an oncology appointment today to discuss the results of his PET and CT scan done this week. Both test came back negative for signs of cancer. Yeah!<br />
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What this means is that there is no evidence of cancer at this time. He will continue to have CT Scans (next one in three months). There is always the possibility that there is cancer floating around that is to small to be picked up by the scans at this time, but at this time the appendectomy may have removed the cancer he had. <br />
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Since regular scans are being performed we should be able to catch signs of cancer early.<br />
If a scan picks up signs of cancer, it could be localized or spread around a large area. If localized there still could be the possibility of surgery to remove what is found. If spread around, then adjunctive chemo could be implemented to prolong life but it wouldn't "cure" the cancer at that point.<br />
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So, a reprieve for now. My attitude is to take this as a good sign and move forward. Tyler has some possibilities of interior design clients and no signs of cancer. My business is doing better and better and I'm still cancer free. The animals are doing well..... life is good in this moment.Robert Denver TChttp://www.blogger.com/profile/14145497055665256073noreply@blogger.com1tag:blogger.com,1999:blog-7595060208965162331.post-33173927402451553092011-08-31T12:11:00.000-07:002011-08-31T12:15:25.954-07:00Try, try until you get the answer you wantWhere we are now......<br />
The abscess has now been reduced/corrected. The stints that were placed in his colon to help drain the abscess came out on their own, so the procedure to remove them went really fast!<br />
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<span class="Apple-style-span">But that still left us with the "what to do about the cancer" debate. We were hearing from the oncologists that Tyler needed to have a right hemicolectomy</span><span class="Apple-style-span"> (removal of about 1/3 of his colon) and 6 months of chemo. The removal of part of the colon (and some lymph nodes) was to determine the existence and stage of the cancer. Obviously Tyler wasn't really into this after all that has gone on.</span><br />
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I was chatting with a friend of mine who reminded me that she had been diagnosed with the same cancer. They didn't do a hemicolectomy and were just monitoring her with scans and blood work. So we got an appointment with her oncologist. Fingers were crossed that Tyler could just be monitored also.<br />
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We drove up to Ft. Collins, CO (about 60 miles north of Denver) for the appointment. The doctor's opinion was that Tyler should just go the monitoring route also. He would have recommended the hemicolectomy if Tyler didn't have his other issues going on. He also could have seen doing chemo although it is now a bit to late to be as effective in relation to the risks posed. He felt there was a better than even chance the cancer has not spread to the lymph nodes based on Tyler's records (previous scans and blood work). The cancer may have been removed along with the appendix. Tyler's tumor was a T3 which means it had invaded the muscle of the appendix, but had not advanced outside of the appendix. Also, during the pathology of the appendix there were no tumor cells at the margins (where the appendix was cut away from the colon). Also, the chemo that was going to be given was for colon cancer since the appendix cancer is rare and there appears not to be a chemo regimen specifically for that type of cancer. The new plan is to do a PET scan and blood work towards the end of September and go from there.<br />
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So, it is kinda like asking Dad for permission and then trying Mom! Keep asking until you get the answer you want. Does this mean Tyler doesn't have cancer? No. Does this mean Tyler does have cancer? No. It just means that in Tyler's situation the risks of surgery and chemo outweigh the benefits that may or may not happen.<br />
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So there is a chance Tyler is over this latest challenge, but it also may mean that the cancer is still active and may reappear other places. But for now, the challenge is that he still has blood in his urine (only seen through a microscope) and tomorrow will be having a cystoscopy procedure to see what is going on in his bladder.<br />
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Robert Denver TChttp://www.blogger.com/profile/14145497055665256073noreply@blogger.com0tag:blogger.com,1999:blog-7595060208965162331.post-4578882265960936312011-07-28T09:14:00.000-07:002011-07-28T09:14:33.723-07:00Another ProcedureTyler had to go through another procedure and 3 nights in the hospital last week. He had been in pain since the appendix surgery and they found an internal abscess/hematoma behind his bladder.<br />
Below is Tyler's posting:<br />
<span style="color: black; font-family: 'Marker Felt', 'Comic Sans', 'Comic Sans MS', sans-serif; font-size: 14px;"><span apple-content-edited="true" apple-content-name="body" applecontenteditable="true" style="display: block;"><span class="Apple-style-span" style="font-family: 'Marker Felt'; font-size: small; line-height: 20px;">Surgery Again</span></span></span><br />
<span style="color: black; font-family: 'Marker Felt', 'Comic Sans', 'Comic Sans MS', sans-serif; font-size: 14px;"><div><br />
</div><div>Yes, another surgery, I don't know how much more my body can take.</div><div><br />
</div><div>Since my appendectomy, I have had severe abdominal pain. Initially, I thought it was just recovery from the surgery and then I thought it might be a urinary tract infection. I consulted my surgical office numerous times but no one seemed to take it seriously. </div><div><br />
</div><div>Finally, through the persistance of my cardiologist, I had a CTScan and they found an abssess and it had to be immediately removed.</div><div><br />
</div><div>I was only in the hospital for 4 days but enough already.</div><div><br />
</div><div>As far as the cancer surgery goes, we have decided to wait for a while and get a second opinion. Removal of the colon, although some what common is a major surgery. And with the LVAD it is even more precarious.</div><div><br />
</div><div>After what we went through with the appendectomy and the complications of the appendectomy we think it is wise to get a second opinion and to make the right decision.</div><div><br />
</div><div>I also think my body needs to recovery fully before yet another surgery.</div></span>Robert Denver TChttp://www.blogger.com/profile/14145497055665256073noreply@blogger.com0tag:blogger.com,1999:blog-7595060208965162331.post-74208335757092361042011-07-14T09:00:00.000-07:002011-07-14T09:00:21.999-07:00And then CancerYep, I said it. Cancer.<br />
Tyler went for his appendix surgical follow-up on June 22nd. The hospital had done a pathology on his appendix and found cancer. It is an Appendix cancer and is very rare. Found in about 1 percent of removed appendix. The cancer was found all along the length of the appendix and may have been the cause of the appendicitis. It is an Adenocarcinoma with Goblet cells.<br />
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Tyler called me while I was at a business lunch and said there was no easy way to tell me this, but "I have cancer". Then he laughed a little. Of course I said ... "Not funny." He said what else could he do at this point but laugh. The surgeon told him the treatment would be removal of the portion of his colon that had the cancer.<br />
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I didn't write about this in the blog sooner because we really didn't know what was about to happen. What kind of cancer? Had it spread? What was the treatment? How much of the colon would be removed? Colostomy bag? Why do we get to have all the fun!?<br />
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Tyler then started doing tests; Colonoscopy, some PET scan like thing, urine tests, blood tests, etc. The colonoscopy came back normal, the scan came back normal, the other tests came back normal. So a doctor called Tyler and let him know the good news was that they would just remove half his colon. Tyler's response: "Doesn't sound like good news to me!"<br />
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So we spent about three weeks saying "What?". And we also spent three weeks going to dark places in our minds. Does he really still have cancer? Is it treatable? Will he have yet another "bag" to carry around? Do we prepare for the worst?<br />
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We decided this was enough of a "push" to get our paperwork in order. Living wills, Advance directives, power of attorney's, Last Will and Testament. Oh the fun of it all. His parents unfortunately went on "alert" again. Again, we decided to spread the word only so much since we didn't really understand what was about to happen.<br />
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On July 13, we went to see a surgical oncologist. Please, oh please, explain this. The doctor first came in and said when he first saw Tyler's case it was a "no-brainer". Observation only. Then he took it upon himself to contact Tyler's other doctors at the hospital to further discuss his case. At that point he changed his mind. Even though Tyler has an LVAD, his other doctors said he was very strong and should be able to handle surgery..... again. So the doctor now was advising going ahead with the surgery.<br />
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The surgery would be a right hemicolectomy. It would remove about 1/3 to 1/4 of his right colon. If everything goes well there would be about 5 to 7 days in the hospital, no colostomy bag, and about two to four months recovery. This is a preventative measure. So at first, we thought "forget it.... observation only." The problem is that by the time a scan or other tests indicated the cancer had spread it would almost be to late to handle the problem. We made another appointment with the doctor in about three weeks while we way the options.<br />
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The other issue is that with a cancer diagnosis, more than likely Tyler wouldn't be allowed on the heart transplant list. Tyler and his cardiologist had already discussed waiting a while to see where technology went with heart pumps, so this wasn't as dire as the doctor thought it would be. <br />
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At first Tyler thought he would just go the observation route. But then after a little while he thought that would just delay the inevitable possibly and any pain he had he would think it was cancer.<br />
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So while a final decision hasn't been made yet, I believe we are leaning towards surgery. Even though they want to treat it as an aggressive form of cancer, it appears we have a little time to think this through and schedule surgery. Possibly beginning of September.<br />
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We are exhausted physically and mentally. The doctor wants Tyler to fully recover from the appendix surgery (hence the three weeks before the next appointment). One doctor commented that his colon was "pristine" and one of the blood tumor markers was elevated but not by much. So it looks like we have a chance to catch our breath before the next surgery.Robert Denver TChttp://www.blogger.com/profile/14145497055665256073noreply@blogger.com1tag:blogger.com,1999:blog-7595060208965162331.post-70416962736751004692011-06-08T09:27:00.000-07:002011-06-08T09:27:44.729-07:00We have to go to the Hospital.6/8/2011<br />
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Obviously it has been quite a while since October 2010. Things have been going relatively smoothly since then. There have been on again, off again issues with blood pressure and his INR (blood-clotting) levels.<br />
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Two days ago Tyler started complaining about a stomach ache. You would think this would trigger something inside of me since it was in Cozumel that he started complaining about pain. But we didn't know if it was something he ate, muscle strain, etc.<br />
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At 5am the next morning, Tyler woke me up and said "We have to go to the hospital now." My reaction was simply to get up, get dressed, and go. Okay, I did brew a cup of coffee. Being panicked just doesn't happen anymore. <br />
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At the ER, they started running test and put him on morphine and diloted for the pain. His white blood cell count was up and they though it might be an infection. I was worried that his drive line might have become infected. Once Kathy, the LVAD nurse came, I went back to the house to take care of some things. Then I got a call and he had appendicitis. Man, Tyler's luck is something else!<br />
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Once I got back to the hospital (the Houston flashbacks were really starting to kick-in!), they were loading him up on Vitamin K to get his blood thicker. Of course they took his INR in the morning and it was 2.2. Finally got it to the right level and immediately they had to start reducing the level so he could go into surgery. <br />
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He went into surgery at about 4:40 pm and I got to wait in the waiting room. More flashbacks. But, I had a good book to read. I was asked later how I could concentrate on reading, but at this point I was just taking things in stride. Nothing I could do at this point.<br />
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Surgery was over at about 6pm. The appendix had not ruptured, but was seeping. The surgeons were able to get the appendix out and clean the area up, and felt good about the surgery. They had to do the old-fashion type of surgery (cutting instead of laparoscopy) due to not wanting to expose the LVAD to infection. I saw Tyler in ICU and he was in immense pain. I was told he wouldn't remember anything last evening, so I got out of there quick! He was in good hands and I needed to get home. Yeah! I could actually go to my house this time!<br />
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Tyler has apologized to me for "messing-up" another celebration. When we were in Cozumel, we were celebrating the end of my cancer. This weekend we were going to celebrate my birthday. Oh, well. I more than fine with him being okay. I talked with his mother and she asked me what I wanted for my birthday....if I had anything specific I may want. My response was, "..in no particular order, a heart, appendix, or testicle would be just fine!".<br />
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Not sure how long he will have to stay in the hospital this time (hopefully less than 4 days). Supposedly Tyler is the first LVAD patient to have an appendix removed. Yeah! Another milestone! :-) Tyler of course had already wooded the staff and some mentioned they couldn't wait to talk to him after surgery. I warned them to temper their expectations. Sure enough, right after surgery Tyler was trying to sit up, wanted to go walking, and informed the staff that the oxygen he was being given wasn't doing him any good! I was asked if I could calm him down after relating a story about Houston in which I was called by an ICU nurse to come and calm him down. I figured the only thing that would calm him down this time was pain meds!<br />
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He is doing well so far this morning and I think he will be fine. He is very strong and should recover well.<br />
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RRobert Denver TChttp://www.blogger.com/profile/14145497055665256073noreply@blogger.com0tag:blogger.com,1999:blog-7595060208965162331.post-44653925262283920982010-10-23T14:44:00.000-07:002010-10-23T14:50:04.524-07:00Resilience - and Anniversary? So, one more day, October 24th, will make 1 full year from the fateful words, "I don't feel good". Wow, I can't believe typing the above sentence still feels like a punch in the gut. But damn (excuse me), what a difference in one year! From death to life. From "life will never be the same" to "life is becoming the same". From "oh my god, I'm going to have to do what?" to not having to do much except listen for alarms every now and then.<br />
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In one year Tyler has gone from death's door to pretty much the same old Tyler. Physically Tyler is doing very well. Last June when I decided to take a solo trip to visit my family, I was pretty confident that Tyler was ready to take over his care. Since then, with some minor backup, I've done nothing. My gig is up. Tyler has taken care of all his meds, supplies, appointments, etc. Even taken a trip by himself to Phoenix. And to top it off, he won a national design award just a couple of weeks ago.<br />
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A friend of ours likes to joke about "how hard it is over at the Anderson/Swoverland household", since we don't seem to be "suffering" enough. When Tyler won the award, he said.. "Oh great, we are going to get the 'oh it is soooo hard over there' speech. It was then that I really started to understand resilience. Notwithstanding the massive generosity of friends and family, in the form of prayers to money, that allowed us to survive the initial part of the crisis, Tyler and I have been resilient in moving forward with the life that has been dealt to us. It took a long time, about 9 months, to feel like we were getting back on our feet. Things are still a bit murky as to how things will continue, but we have survived and continue to push forward.<br />
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Tyler has done some smaller jobs and continues healing. He is getting physical therapy on his leg and it seems to be helping a lot. More pain, but we still take that as a good sign for nerves coming back in his leg and foot. No ER visits and no real excitement with the pump. He is feeling a pain in his abdomen on the side where the pump is and will be checking that out this coming Monday. The one worry may be that the pump has attached itself to the abdominal wall. So they will do an ultrasound or X-ray to check things out.<br />
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So, wow, one year later. Tyler is moving around better, cooking again (thank god!), reading again, staying up late and sleeping late (okay, that one is new), and truly is so much better. I'm still cancer free, the animals are doing well, and life just keeps moving on. To think back to the night of October 25, 2009 (the first night we got to St. Luke's), when I stood outside staring at the medical center buildings in Houston and wondering what in the world I was about to face, and to sit here now in my house with things basically back to normal, is truly a testament to resilience and the power of family and friends!<br />
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RobertRobert Denver TChttp://www.blogger.com/profile/14145497055665256073noreply@blogger.com0tag:blogger.com,1999:blog-7595060208965162331.post-53989178341358168612010-09-04T07:58:00.001-07:002010-09-04T07:58:50.996-07:00Janet and DavidI've mentioned Janet and David in some of these past postings. They are the couple we were introduced to in Houston that had an LVAD. Both Janet and David helped Tyler and me immensely in understanding (and witnessing) day-to-day life with an LVAD. David had received his LVAD about 5-6 months before Tyler. In the early weeks of our event, I was introduced to Janet by the staff at St. Luke's. Janet graciously sat down with Tyler's parents and me to start sharing her experience and knowledge about life with an LVAD and trying to get on the transplant list. Janet was one of the angels sent to me during this crisis. Yes, some of the information imparted to me seemed overwhelming at the time, but Janet's stoic stance and determination helped me to see that this situation could be dealt with. Over the months Tyler and I were in Houston, Janet and David were always there for us. When I would take a trip back to Colorado, Janet would come to the hospital to hang with Tyler. When Tyler was out of the hospital, Janet and David would come over to the apartment to talk and continue to help us through the "maze". One of the most notable interactions between us was when Janet told Tyler that he wouldn't be able to use a vacuum cleaner any more due to the possible static electricity. Poor Janet, she thought this would be a positive for Tyler. She was mistaken. Tyler was none to happy about this restriction and let us know that immediately. Janet had a shocked look on her face as she thought Tyler would be over-joyed by this news.<br />
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David went in to the hospital a few weeks ago to have his LVAD upgraded to the new model. Unfortunately he started experiencing many issues related to the surgery and battled for weeks with different problems. On September 2nd, 2010, David lost the battle and passed away. Janet and David fought a very long struggle but always maintained a fighter's attitude. Janet dedicated her life to their struggle and to helping others going through this same struggle. The last several weeks were very stressful and hard on Janet and showed just how hard being a caretaker can be. Janet was a strong role-model.<br />
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I am very sad for her as she has been going through hell not only for the past few years, but a particular hell this past three weeks. My heart truly goes out to her and her family and hope that they can start moving forward again with the knowledge that they have performed the hardest job someone can ever have in life and did it with flying colors. <br />
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RobertRobert Denver TChttp://www.blogger.com/profile/14145497055665256073noreply@blogger.com2tag:blogger.com,1999:blog-7595060208965162331.post-14732067644499797722010-08-04T08:55:00.000-07:002010-08-04T08:55:40.648-07:00John Doe - Gunshot Wound8/3/2010<br />
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Tuesday seemed like a pretty normal day. Tyler walked the dogs in the morning and we both worked like normal. Tuesday evening decided to be exciting.<br />
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Just after finishing dinner, while watching TV, Tyler started to tell me he was dizzy, having double-vision, and a bit nauseous. Like everything theses days it started off as a "wait-and-see" event. He then mentioned that he felt like this in the morning also. I told him to call the VAD coordinator just in case.<br />
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He sent a text to the Kathe, the VAD coordinator, but then didn't remember sending the text or changing his batteries or talking to DJ on the phone. Kathe texted back asking a couple of questions and then called. We started discussing the symptoms and Kathe decided to call Dr. Brieke. While waiting for the doctor to call back, Tyler's nausea came back and he vomited. We then tested for a possible stroke. Eye movement, hand grip, facial muscles.... It seemed like Tyler's blood pressure had dropped or it could be that he was just sick. Once we told Kathe about the very short term memory loss, the night became exciting.<br />
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Tyler had decided to lay down in bed and go to sleep. Kathe had other plans for us. I got Tyler up and we drove to the ER at the hospital. This was about 8:30pm. Neither of us were panicked (although I did almost side-swipe a car on the interstate ). We got to the ER and were admitted immediately. I wished I had brought a pen and some pictures of Tyler so he could sign autographs. Everyone wanted to come see the LVAD patient since they rarely get one in the ER. They took his vitals and things seemed fine. Tyler was actually feeling better by this time. He also mentioned that he has been having headaches for the past couple of weeks, so a CT scan was ordered. A mention was made that they might admit him for overnight observation. Tyler's response: "No. No I'm not staying overnight. I shouldn't have mentioned anything. I'm not staying." We agreed that if nothing significant was discovered we were going home.<br />
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The initial wave of doctors/nurses/paramedics coming in to see the LVAD had died down and things were quite while we waited for the results of the CT scan. Then we were told paramedics were bringing in a gunshot victim into the same ER room we were in. The activity picked up again as everyone was rushing to prepare for the new arrival. Curtains were drawn between us and where the victim was going to be and they brought in a 16 year old gunshot victim. Tyler, Kathe, and I stayed huddled very close to Tyler's bed while listening to all the activity going on. The scene wasn't quite like the TV hospital shows. Granted, lots of activity, but just not as dramatic. It seemed like within minutes the doctors and nurses had things under control and moved the victim to an OR room. <br />
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We got the results of the CT scan and things looked fine. We think Tyler drank to much water during the day and depleted his sodium. So now the remedy is to drink some juice, infused water, or Gatorade in addition to the water he is drinking. He is also going to have an echo-cardiogram this Friday. They are still feeling a pulse and may have to adjust his pump. They are a little concerned about possible "suction" events. Basically if his left ventricle is pumping more than the pump, it creates a suction of the flap between the right and left ventricle. (Reminder: I'm not a doctor and only play one at home. I may not have this info exactly correct.) If this is the case then they will adjust the pump speed. I'm still hopeful his left ventricle his getting stronger. I mean we are talking about the "miracle child" and Tyler has beat all expectations already.<br />
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We got back home around 1:30am and went to bed. Today has started out normal again so fingers crossed!<br />
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RobertRobert Denver TChttp://www.blogger.com/profile/14145497055665256073noreply@blogger.com0tag:blogger.com,1999:blog-7595060208965162331.post-90496957526809642672010-07-29T12:35:00.000-07:002010-07-29T20:50:13.500-07:00Indiana and a PulseOur trip to Indiana was basically uneventful, well kinda......<br />
Our first night of the trip, when we stopped in Des Moies, IA, the battery charger showed the "broken-battery" symbol when we put the batteries in. Going from memory, I thought I was supposed to push and hold the specific battery's button, which would re-calibrate the battery so that it could hold a full charge. I did this and saw no indication that it was re-calibrating. The down side of re-calibrating is that it first drains the battery completely, then recharges it (about a 12 hour process). I tried looking on the Thoratec web site for instructions but couldn't find any. I talked to Kathe, the VAD coordinator at UHC, and confirmed it doesn't show an indication. While in Indiana, I noticed one of the batteries in the charger had a red light on. This meant the battery was completely dead. Once again Kathe came through and had replacement batteries to us the next morning in Fort Wayne.<br />
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The trip to Indiana was going well. Tyler's family was very busy getting donations for the benefit on July 16th. Susie, a family friend, had instigated the benefit after we had decided to visit. She, along with Tyler's high school drama teacher Harold, were able to secure the Churubusco High School cafeteria to hold the benefit. There were many local business that donated items and notices were put in the local shops in Churubusco.<br />
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About 5 days before the benefit, Tyler and I went to Lake Wawasee to hang out with our friends the Lahren's. We took their boat out and "docked" at a sandbar in the middle of the lake. Renee was worried about what to do if Tyler fell into the lake. Basically, you pull him out and make sure the controller didn't fry and if it did, use the backup controller. We had no incidents and everything went fine. Of course, when we driving back to Tyler's parents house, we realized we didn't have the backup-bag. Where was it? Oh, on the boat. Luckily the Lahren's hadn't quite left and were able to grab it and bring it to us back in Fort Wayne. It is amazing how easy it is to forget stuff since Tyler is doing so much better now. For the boat, Tyler took his shower bag so that the controller and batteries would be protected from water splashing and everything went fine.<br />
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I took a short trip to Albany, NY from Fort Wayne to visit my sister and her family. Very nice trip and I figured everything was basically going well back in Fort Wayne. Well, maybe it wasn't. Tyler was out with his father and his "15 min. battery alarm" went off. He silenced the alarm and then forgot about it. An hour later the "5 min alarm" went off. He had his backup batteries with him so it wasn't a emergency, but doing these "tests" to see just how long the batteries will go maybe isn't the best thing.<br />
Also, Tyler called me on my ride to the Albany airport to return to let me know his mother had been taken to the hospital because she became extremely sick the day before. It ended up being a small bowel obstruction and she had surgery on the day of the benefit. She ended up spending about 5 days in the hospital. We are being told by some that Tyler and I leaving Colorado is a danger to us and others and maybe we should be allowed to travel!<br />
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The fundraiser went very well. I was a little nervous and preparing for a meeting a lot of people and Tyler thought only a small handfull of people would show up. Well, it was a lot more than 20 people. I'm not sure how many came, but seemed like around a hundred or more. Everyone was wonderful and very glad to be able to see Tyler in the flesh. Just like the Denver benefit, the turnout and support was overwhelming. Relatives, cousins, high school friends and teachers, on and on. The benefit lasted from 6pm to 9pm and while Tyler was a bit worn out, he was extremely happy to see everyone. <br />
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The drive back to Denver was pretty uneventful and we were glad to be back home.<br />
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Tyler had his monthly checkup last Monday and the nurses felt a pulse. He isn't supposed to have a detectable pulse, just a continuous flow. So what does this mean? Dr. Frasier at St. Lukes/Texas Heart Institute, had made comments that maybe given enough rest and healing time, Tyler's heart may repair itself. The larger consensus was that the damage was to much to heal. But, Tyler is of course the "miracle child", so who knows. It would be the ultimate outcome to not need a transplant and be able to remove the pump.<br />
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So, thank you to everyone who turned out for the benefit. And thank you to Susie, Tyler's family (I'm thinking about you Temple!), and everyone else that helped out.<br />
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Now back to work,<br />
<br />
RobertRobert Denver TChttp://www.blogger.com/profile/14145497055665256073noreply@blogger.com1tag:blogger.com,1999:blog-7595060208965162331.post-72065447017411189602010-06-28T15:11:00.000-07:002010-06-28T15:11:00.275-07:00LVAD SocialToday we went to Univ. of Colorado Hospital's first LVAD Social. I'm not sure if this was the official name of the event (okay, it was Mechanical Circulatory Support Meeting or something like that, but I'm calling it a social). It was very good to meet the other LVAD people in the Colorado area. In fact, we met one woman who had just gotten back from St. Luke's where she had Dr. Kar as her doctor and Peggy as her VAD coordinator. And she went through the same floors as we did. Made me miss the St. Luke's staff (and gave me some very weird flash backs). She told us that we were mentioned to her while she was there.<br />
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The group was a mix of ages and most have the LVAD as a destination therapy (not going to be put on a transplant list). In fact the woman we met won't be available to be on the list for 5 years as she had just finished chemo the week before her heart event. Kind of made me re-evaluate our bad luck...... maybe it wasn't as bad as it could get! Everyone was very nice, talkative, and very upbeat. Some had just gotten the LVAD while others have had there LVAD for years. <br />
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We also went to clinic today and things still look pretty good. Tyler's INR ratio dipped slightly, but not enough to change anything. We were able to have a good "heart to heart" (pun intended) with Dr. Brieke about life with an LVAD vs. a heart transplant. It has been good to have the time to weigh the risks and benefits of both so that we are ready for the next step when it happens.<br />
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We are taking a trip to Indiana on July 8th so Tyler can visit friends and family. We are going to drive instead of flying so we can avoid the airport security headaches with all the equipment we'll be taking. This also gives us the opportunity to take the dogs (Toby and Bowser) with us on the trip. Should be interesting!<br />
<br />
RobertRobert Denver TChttp://www.blogger.com/profile/14145497055665256073noreply@blogger.com1tag:blogger.com,1999:blog-7595060208965162331.post-69137878813785277992010-06-22T19:28:00.000-07:002010-06-22T19:28:52.212-07:00Doctors and more DoctorsSo what has been happening since April? <br />
Life has calmed down somewhat, but Tyler continues to have multiple doctor appts. Orthopedic, General, Cardiology, Neurology, Psychiatry & VAD clinic. Due to the meds, which caused constipation, Tyler developed a hernia. At first there was going to be surgery, but now that he is off the Fentanyl and has reduced the hydrocodone, it appears the groin hernia is reduced enough that surgery isn't necessary. There are still some other issues, but due to decorum I wont' go into those. I figure talking about his constipation is good enough for now. His leg is getting better and better. The neurologist said that the damaged nerve was his sciatica. Great. Now he can walk around saying, "oh, my sciatica!" like an old man. But they also said from their test that they expect full recovery. They also said the pain will probably get worse as the healing continues.<br />
With the Univ. of Colorado Hospital staff, we have been able to adjust some of the meds (reducing some and eliminating others). His INR (blood clotting factor) dropped a bit (to about 1.2) and they added an extra amount of Warfarin Sodium. This got the level back to where it was supposed to be. <br />
<br />
We lost power to the house in May and what a fun time that turned out to be. We were asleep when the power went out and the main power unit that Tyler is hooked to at night let us know the power was out with piercing alarms. Tyler switched to batteries and we thought "that was that" and went back to sleep. Unfortunately the power came back on and then went back off. More alarms. Finally, in the dark, we were able to disconnect the cables so it would quit alarming. I wondered how long the power would be out before we would need to make some plans.<br />
Well, it seems being on the power companies list really works. Kudos to Xcel Energy. About and hour after the power went out, the crews were outside the house working on things. At 8am there was a knock on the door. The power had been restored but guess whose trees were causing the problem! <br />
<br />
We are now in June and Tyler is getting stronger to work out with his trainer Lasha. The hospital staff has been impressed with his efforts. There was even mention of trying a 5K. We'll see.<br />
<br />
It is good to be home and Tyler continues to try and figure out the next steps. For now he is still not on the transplant list. At first we were not happy about this (let's get this over with!.... Robert is tired of blogging!), but this has turned out to be a good thing. It has given both of us some time to adjust before the next big thing. Tyler is also now dealing with his own meds (scary) and changing his dressings. He continues to become more and more independant.<br />
<br />
I've been following my friend Janet's (Houston) Facebook postings. Appears a family that was there when we were (Chessers) are having issues with a heart transplant rejection. Tyler and I talked a bit about this and he is still trying to get his head around having the heart transplant. A little more time on the LVAD will hopefully give him the time to figure things out.<br />
<br />
Other than that, I continue to try and make things work at work. Tyler is still trying to figure out how to rebuild and how we will deal with things. But thanks to the wonderful benefit in Denver last fall, we have been able to make it to this point. Life is actually good, just scary at times. Tyler and I took the dogs for a walk last night. I was riding my bicycle and rode ahead to the house. After a while I took the bike back out because Tyler still wasn't home. Yes, the thought ran through my mind! Of course, there was Tyler talking to a neighbor. Sometimes things actually don't change.<br />
<br />
RobertRobert Denver TChttp://www.blogger.com/profile/14145497055665256073noreply@blogger.com0tag:blogger.com,1999:blog-7595060208965162331.post-61229494051960118352010-04-14T15:34:00.000-07:002010-04-14T15:42:13.320-07:00Still Waiting ....."Not motivated for a heart transplant". <br />
<br />
Seems Tyler and I might be a bit to grouchy for a heart transplant. I guess our interview with the transplant social worker didn't go so well. Hmmmm, why were we grouchy that day? Okay, we got word that Tyler isn't on the transplant list yet. Wasn't a final no, just some concerns. The leg issues and narcotics for the pain is one and valid. As for not being motivated or not understanding the importance of a transplant..... not buying that one. If so, then I'd rather be in the Caribbean being unmotivated. We just had a bad interview (wasn't horrible, but we have been a bit frustrated lately). Dr. Brieke (Cardiologist) and Kathe (one of the VAD coordinators) are fighting for us. Kathe is even checking up on my health and I think has become my "Stephanie" (St. Luke's transplant coordinator) in Colorado. That is a big compliment, but I don't want to fan any flames of competition between Denver and Houston!<br />
<br />
Tyler has an appointment with a director of the list April 19th so that the UCH staff can meet Tyler and get to know him and our situation better. We will meet the transplant team more as time goes by and everything will be fine. Sometimes I think Tyler and I can be a handful for the hospitals! I even mentioned that I was going to have to "re-engage in this full time again" if things didn't start progressing better. Tyler is handling his care and I want Tyler to control his "destiny", but I may be getting a bit impatient. Must.... control.... my.... control... issues! <br />
<br />
Tyler has taken great strides in developing the strength in his bad foot. The neurologist thinks it is stronger than his "good" foot. He also continues to try and gain more weight (up to a limit...I mean we are talking about Tyler and you know, <i>god forbid</i> he gets fat.) He has also gained more independence and is able to make short errands by himself. He still gets tired and takes naps that are usually 2 hours or so.<br />
<br />
There was another comment concerning listing on the transplant list: "... he is doing fine on the LVAD". Tyler's response was "...let them have an LVAD as see how <i>fine</i> it is.". I, on the other hand, went through the stages of coping in about an hour. I'm getting much faster at it. I went from "What?!" to "....I'm going to bomb so and so", to "eh, it will happen when it happens" pretty quick. And it <b>will</b> happen when it is ready to happen. We just need to "meet" the staff at UCH more. I forget that my "meeting" with St. Luke's was intense and they were able to figure us out since there was so much "quality" time together! I still miss my Houston team, but Colorado will pull through....no doubts.<br />
<br />
Disability payments haven't started yet for Tyler and maybe they will in May. The will only go back to a March date since there is a 6 month period before being eligible for payments.<br />
<br />
We have had some bigger fights and both have wanted to just walk away. But, we get over that intense moment or moments and keep moving forward. We still have days of depression and it appears I have taken to grinding my teeth in my sleep at night but only about 3 times so far. We tend to alternate depression days. But we are still kicking (and screaming) along....<br />
<br />
We had another "alarm" event. We were being graciously treated to a dinner out with his parents from Lucy and Andrew at Elway's restaurant. It is a very nice restaurant and was wonderful treat. During salads we heard the battery alarm beeping. This was the '15 minutes' remaining alarm. Tyler and I went outside and swapped the batteries. Decided we shouldn't do that in the middle of the restaurant. I think we worried a couple of people but for us it was just another day. We have become used to this and take it in stride, but it still tends to freak out some people. For me at least, it is still better than last fall.<br />
<br />
<br />
RobertRobert Denver TChttp://www.blogger.com/profile/14145497055665256073noreply@blogger.com1tag:blogger.com,1999:blog-7595060208965162331.post-4180954122363341992010-03-09T17:17:00.000-08:002010-03-13T08:04:26.014-08:00Looking for a rock..........to crawl under.<br />
<br />
What has been/is going on:<br />
<ol><li>Three consecutive days of heart transplant evaluations planned for March 16th - 18th. University of Colorado Hospital (UCH) wants to do a full slate of evaluation tests before placing Tyler on the transplant list. Of course Anthem Blue Cross doesn't want to pay for evaluations that were already done in Houston. UCH and Anthem are supposedly working out what tests will be done and paid for. Otherwise we would have to come up for the money to pay for the tests. And if the tests aren't done, no listing on the transplant list.</li>
<li>Still waiting on Anthem Blue Cross to approve, deny, or partially pay the Cozumel medical expenses including the air flight. We are stuck waiting for them to play the paper work shuffle games before we can file with the travel insurance. Even if Anthem would just deny the claims we would be better off, since we could send what we need (again) to the travel insurance company.<br />
</li>
<li>My kidney stone surgery. Surgery went well and I had thought it went extremely well since I never felt any pain. Found out I still haven't passed the fragments. They are still sitting in my kidney. I would like just one of our ailments finished off. Maybe I'm asking to much? I'm sure the fragments will pick the most appropriate time to pass (like during a business meeting).<br />
</li>
<li>Tyler caught his drive line in a car door. Also fell down a couple of exterior concrete steps and skinned his knee (yes, the knee on the bad leg). Luckily he is on blood thinners....oh wait a minute. Tyler called me to let me know what had happened so I figured since he was talking there was no reason to panic. He thought the same thing. Amazing what doesn't cause a panic anymore. He only split the cord cover a bit and barely exposed the internal wires. Went to the hospital and they taped it up and did an x-ray. Luckily none of the actual wires were damaged. They tested to see if there was damage to particular wires in the cord. Certain wires interact with the batteries and others to the power base unit. So you could cut some wires and have the batteries still work but not main power, or vice versa. Previously, if the cord was damaged, it would mean replacing the LVAD by having open heart surgery again. Thankfully there is now a repair-kit approved by the FDA. You can pick it up at any local hardware store....<br />
</li>
<li>Been to a couple of VAD clinics at UCH. Anne and Kathe, VAD Coordinators, are great and funny. So far Tyler's blood work has remained in the range they want. Dr. Brieke, his primary cardiologist now, has a very nice laid back style. We have also met Dr. Reece and Dr. Cleveland, the heart transplant surgeons.<br />
</li>
<li>A new year started for my insurance coverage and I have already had to meet the yearly deductible due to charges for oncology CT scans and x-rays, and the kidney stone surgery.</li>
<li>Tyler not wild about going through a heart transplant and sometimes feels like he would rather stay with the LVAD. I still would like him to get the transplant. No more wires, can sleep in whatever position he would like, and (the most important) he could use the vacuum cleaner again!<br />
</li>
<li>I sold my car. Just using Tyler's car for now. We'll see how that works out when Tyler is ready/able to drive again. But for now the extra monthly income will help out a bit.<br />
</li>
<li>Tyler's parents coming for a visit. Haven't seen them since I used to live in Texas. I've fallen out of touch with them a little bit because Tyler is able to talk. But it will be nice to see them again.<br />
</li>
<li>Tyler and our neighbor, Karen, took the dogs for a 45 minute walk. Tyler did this without using his cane and it went well. So the leg/foot is still improving. Still painful, but getting stronger. Still need to get his weight up. But he is now off the Nexium (acid reflux) and Furosemide (diuretic) pills.<br />
</li>
</ol>As for life in general....not so great lately. We are still pushing through each day but it gets depressing. The medical bills are piling up, not sure about the transplant listing, still wondering what is going to happen, work income isn't enough to cover all the costs, and for me .... I can't seem to get a plan in place. Trying to decide if I should get a second job, but that wouldn't give me the flexibility to be available for cut cords, etc. Tyler is trying to decide what to do about bills and debts.... wants to hold on to his good credit rating and do the right thing but without being able to work and still waiting on a heart transplant, it seems insurmountable. Still waiting for disability payments to start. We are both worried about hitting Tyler's lifetime insurance cap with Anthem and what to do about future insurance for Tyler. Bowser, the lab, got an ear infection. Juggling my work needs (have two out of town trips coming up) versus what help Tyler needs. Does he need someone to stay overnight or not. But this is up to Tyler. There are LVAD patients that live alone, so he'll basically need people "on-call" just in case something happens.<br />
<br />
Then for me there is the intermittent wondering, when things are very quiet, if Tyler is still alive or just napping. I know the last statement was pretty heavy and it isn't as if I'm scared that would be the case, but the thought does run through my mind every now and then. Just part of this experience.<br />
<br />
Then there is the uncertainty of what we will be able to do since our relationship is "unrecognized" by the federal/state governments. Okay, a political moment. We are in this together but we have to make sure that if we aren't entitled to any "benefits" in this relationship, we are also not required to satisfy the "responsibilities" of a recognized relationship. Sorry, the government can't have it both ways. Okay, they can, but it doesn't mean I have to like it. <br />
<br />
About two weeks ago I finally felt glad to be home. There were just to many adjustments/responsibilities to go through at the beginning. But we are home. I do miss my Houston buddies .... St. Luke's staff, Janet and David, and all the great people that helped me through the beginning of this. We haven't met other transplant patients in Colorado and it was nice to be able to commiserate with Janet. David had his own scary issue come up due to a staph infection. Luckily it didn't infect the drive line and his is okay.<br />
<br />
I miss the days of just getting a cold.<br />
<br />
It was hard to put out posts to the blog in the past month because I wasn't sure what to write and wanted to concentrate on work. The challenges also seem/seemed overwhelming and I feel like I'm whining. And it isn't fun to write about being depressed. But I haven't really been in the mood to do the "keeping our chins up", "hoping for the best", "we'll pull through", type of writing. But, I keep trying to remember that if I can believe that bad unexpected things can happen (cancer, heart attack....), then I need to believe that good unexpected things can happen. Like having Ed McMahon show up with my Publisher's Clearinghouse prize.....oh, wait a minute, he's what? .....damn! Guess that isn't going to happen.<br />
<br />
Unfortunately for my mother, we had two consecutive phone calls where she caught me at my lowest. She thought I should ask my doctor about taking anti-depressant pills. I joked with her saying my doctor said that was what mothers were for. ;-) I appreciate the concern, but I'm not quite ready for pills. Amazingly I think Tyler and I still have fight left in us. I'm not sure what the other side of this will end up being, but sometimes I wish it would just get here faster. <br />
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RobertRobert Denver TChttp://www.blogger.com/profile/14145497055665256073noreply@blogger.com1tag:blogger.com,1999:blog-7595060208965162331.post-48068183140566287812010-02-14T05:53:00.000-08:002010-02-14T06:32:21.811-08:00No pain, no gainWe are both doing fairly well. Tyler should be placed on the transplant list again sometime next week. Looks like he will be a 1B status. The transplant surgeon commented that typical wait time is between 6 weeks and 8 months, with about a 14 day average recovery. <br /><br />We met with a neurologist about his leg/foot issue and they will be scheduling a nerve test to further diagnose the nerve damage. But the neurologist felt that the nerve(s) were regenerating and should continue to get better over time. Still trying to deal with the pain medicine so that a good balance between pain and the number of meds can be found.<br /><br />Tyler continues to do his cardio exercise. Lasha, a friend, comes over about 2-3 times a week and takes Tyler to the gym. His walking is getting better, but since he still can't really feel his foot completely, he is still walking with a cane and can't drive.<br /><br />I've returned to working more while scheduling Tyler and my doctor's appointments. I had my kidney stone checked out and will be having surgery March 1st. The procedure is Extracorporeal shock wave lithotripsy (ESWL). Basically sound waves are blasted at the kidney stone to break it up, so that it can pass. The kidney stone has been lodged in my kidney since last year. The doctors knew about the stone last year, but wanted to attack the cancer first. The stone is not really causing any massive pain right now but I don't want to wait until it dislodges. Hopefully the surgery will break up the stone enough that it will pass through somewhat unnoticed. So, I finally will get some pain meds also! What a sight our house will be those couple of days! There is also a hydrocele that has developed and may require a hydrocelectomy. I'll let those interested look that up on the web (<a href="https://health.google.com/health/ref/Hydrocele">https://health.google.com/health/ref/Hydrocele</a>).<br /><br />We both keep plugging along looking for the end of this tunnel. Most days are just about getting through the day and are pretty uneventful. There are days that both of us express just packing up and running away. Tyler continues to try and deal with the medical bills coming in and whether they are correct or should be paid for. Still waiting for information about disability payments and insurance reimbursements. I've sold my car and we have re-financed Tyler's car to get the monthly payments lower.<br /><br />The Univ. of Colorado Hospital is doing pretty well so far. The VAD coordinators are great and we are just trying to learn a new system of who to bug about what and when. In comparison to St. Luke's I think what I miss is the "built-in" staff of doctors. The cardiologists, neurologist, pain medicine doctor, surgeons, fellows, physical therapists, etc. But basically we just have to set up that group in Colorado and rely more on the VAD coordinators, who will guide us through this process.<br /><br />We had a small glitch when Tyler's Fentanyl patch strength was increased from 12mcg to 100 mcg. A little to much to say the least. Made Tyler clammy and nauseous and made him vomit. We went back to one of the 12mcg patches and are getting a new script for just 25mcg. This is in hope that with the slightly higher Fentanyl dose, he can reduce the Vicadin tablets.<br /><br />So, my hope that 2010 would be all good news isn't quite coming true. But we are still here, in our house, and with our pets. Hopefully the good news for 2010 will be a new heart so that Tyler doesn't have to carry around batteries, I remain cancer free, and no more surgeries for Robert (and just one more for Tyler).<br /><br />RobertRobert Denver TChttp://www.blogger.com/profile/14145497055665256073noreply@blogger.com0tag:blogger.com,1999:blog-7595060208965162331.post-10403381897548696232010-01-27T07:02:00.001-08:002010-01-29T07:06:18.292-08:00PicturesA few pictures as I try to get the rest online. I now have a link above to see the pictures from Houston, or you can click here: <a onclick="window.open('http://www.flickr.com/photos/rgadenver/sets/72157623182550023/')"><u>Pictures</u></a><br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgGFgsO5BHWhBW_q8u1NUsk2pSEeWh8-2hw6-MOkW9u9cEMJ-NB-DWVFdaQtc4h1p1YA0EPB97AGNRpOGpZ-LDqQ9mSttvpwpkAItNYhUj1iBgESURpvTeX9BLE9tSh9IqT6KNLPLeUEZM/s1600-h/IMG_0702.JPG"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgGFgsO5BHWhBW_q8u1NUsk2pSEeWh8-2hw6-MOkW9u9cEMJ-NB-DWVFdaQtc4h1p1YA0EPB97AGNRpOGpZ-LDqQ9mSttvpwpkAItNYhUj1iBgESURpvTeX9BLE9tSh9IqT6KNLPLeUEZM/s320/IMG_0702.JPG" border="0" alt=""id="BLOGGER_PHOTO_ID_5431437530527752722" /></a><p align="center">Tyler ready for one of our "pre-release" outings while at St. Luke's.</p><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgExRD5u-K1i6mCSMRZZDn9z7knTlvKe28avhav75EfnhhbrrenfVfTx145eUDQnKRCd9kYn-lwiUzdkILhyphenhyphenr-ZqIFJCR5dWVk3VS9oSqJ3pVELKQo1hll-vLigJXZaKa3IBoHb7IoPpYQ/s1600-h/IMG_0701.JPG"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgExRD5u-K1i6mCSMRZZDn9z7knTlvKe28avhav75EfnhhbrrenfVfTx145eUDQnKRCd9kYn-lwiUzdkILhyphenhyphenr-ZqIFJCR5dWVk3VS9oSqJ3pVELKQo1hll-vLigJXZaKa3IBoHb7IoPpYQ/s320/IMG_0701.JPG" border="0" alt=""id="BLOGGER_PHOTO_ID_5431437819796515250" /></a><br /><p align="center">Tyler and Keith (another LVAD patient) in Tyler's hospital room.</p><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhoca-c-1AbSaLPAwjsEF6KA4oUhp_hk4rTiHO4NCHWpqpe5bxohwDyJh3sgIODyIQiE-mQnC2ZZVrG1yCxS1mWWdElllPtW6QJftRmdusOHAPZeLRFje1q_dC123S0cRmMhTiTEkpNn_I/s1600-h/IMG_0703.JPG"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhoca-c-1AbSaLPAwjsEF6KA4oUhp_hk4rTiHO4NCHWpqpe5bxohwDyJh3sgIODyIQiE-mQnC2ZZVrG1yCxS1mWWdElllPtW6QJftRmdusOHAPZeLRFje1q_dC123S0cRmMhTiTEkpNn_I/s320/IMG_0703.JPG" border="0" alt=""id="BLOGGER_PHOTO_ID_5431438736222463634" /></a><br /><p align='center'>Robert changing Tyler's dressing.</p><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgYucaxRnrRYsLcUv__eXlQ0P_MKyc0kS_wyrWIWCdg91QDFzFpF2PyTwBqHcgdFYnLv-C1Y-MEiIvI9EnIraPQyw7XCIdY4HTRUeWtqIQfuSSQHXc160nWqHlo2C3_W5kE6oj3uqvvV-E/s1600-h/IMG_0745.JPG"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgYucaxRnrRYsLcUv__eXlQ0P_MKyc0kS_wyrWIWCdg91QDFzFpF2PyTwBqHcgdFYnLv-C1Y-MEiIvI9EnIraPQyw7XCIdY4HTRUeWtqIQfuSSQHXc160nWqHlo2C3_W5kE6oj3uqvvV-E/s320/IMG_0745.JPG" border="0" alt=""id="BLOGGER_PHOTO_ID_5431439200851088866" /></a><br /><p align="center">Tyler's scars and cord.</p><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEihD7h8HFVN1qj2duH0AfCiRL1w4jYUDYSvQsG-Km4cmmC0lp7AvjQFXGvJ9LAFoe7CpZggIA_e9HfNadPg0a7mQs91pt_PL_5rDMhy1Zp_2IkCPTxg6pqdu98Da0l9MY4KHn2SV382Ivo/s1600-h/IMG_0748.JPG"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEihD7h8HFVN1qj2duH0AfCiRL1w4jYUDYSvQsG-Km4cmmC0lp7AvjQFXGvJ9LAFoe7CpZggIA_e9HfNadPg0a7mQs91pt_PL_5rDMhy1Zp_2IkCPTxg6pqdu98Da0l9MY4KHn2SV382Ivo/s320/IMG_0748.JPG" border="0" alt=""id="BLOGGER_PHOTO_ID_5431440138944883090" /></a><br /><p align="center">Janet and David (David has an LVAD also). Our neighbors and friends and most importantly, mentors, in Houston. They lived in the same apartment complex. Tyler is in the background doing what Tyler does best....talking.</p>Robert Denver TChttp://www.blogger.com/profile/14145497055665256073noreply@blogger.com0tag:blogger.com,1999:blog-7595060208965162331.post-42026017507003118222010-01-25T17:37:00.000-08:002010-01-27T06:43:25.567-08:00Colorado - UCHTyler and I had our first full appointment with the University of Colorado Hospital staff. We met with the medical doctor, nurse, circ support, and the heart transplant coordinator. Tyler had a 40 minute echo-cardiogram and the LVAD rpms were adjusted a little higher, to 9600, which should give him a little more energy. As if he needed more! Very hard to get him to rest, but as he says .."I have things to do".<br />The UCH staff was very friendly and jovial. The interaction between them seemed very collegiate. The "appointment" only took four hours. We were very tired afterward and experienced a little of that "information overload" feeling again. <br /><br />Tyler's blood work came back very good. All the levels are where they want him to be and his anemic level is getting better. After looking over the current medications, we were able to remove the Dipyridamole. UCH sent in the form to our utility company so that if the power goes out we are on the priority list. UCH is also contacting the Wheat Ridge paramedics to inform them of our situation and the LVAD.<br /><br />We still have to go through a transplant evaluation before he is listed active again on the heart transplant list in the Denver region. That evaluation is now set for February 4th. We found out that there are currently 10 people active on the heart transplant list in the Denver region. <br /><br />One of Tyler's "things to do" is going through the medical bills, which is becoming the most confusing aspect of this whole event. One bill came with just a line that said "Balance Forward" and no explanation of the charge. When Tyler called about the charge, the comment he got was: "Well, it is complicated." Well, if you want to get paid, uncomplicated it! It will take some more months to sort out what is actually owed and how much insurance is actually going to pay, so in the meantime the bills wll just have to be filed.<br /><br />I had my oncology scans and am still cancer free. They did find a kidney stone and I'm going to have that checked out today. I guess I'm just trying to see if I can have as much pain as Tyler. It will make for a very loud household!<br /><br />RobertRobert Denver TChttp://www.blogger.com/profile/14145497055665256073noreply@blogger.com0tag:blogger.com,1999:blog-7595060208965162331.post-89264730616305945352010-01-19T15:43:00.000-08:002010-01-20T12:50:21.849-08:00JOY! JOY! JOY!As you all know, from this wonderful blog that Robert has created, that we are now home. I just want everyone to know, once again, how thankful I am for all of the love and support you have shown both of us during this time. I am working on contacting everyone personally. <br /><br />I have been out and trying to get my strength back.<br /><br />We will continue to need your prays and support as we get ready for my heart transplant. Thankfully it will be taking place here in Colorado. We are hopeful that we will be put back on the active list at the end of this month.<br /><br />Again, thank you and we love you all!<br /><br />TylerRobert Denver TChttp://www.blogger.com/profile/14145497055665256073noreply@blogger.com1tag:blogger.com,1999:blog-7595060208965162331.post-5273865710573813832010-01-16T07:18:00.000-08:002010-01-16T08:04:19.287-08:00Good to be homeTyler and I made it home on Tuesday the 12th around 4pm. We made the trip in two days and stopped for the night on Monday in Blackwell, OK. When we left Blackwell it was about 20 degrees and heavy fog. The fog lasted for a couple of hours on our drive and started to dissipate once we were on I-70 headed west. The closer we got to Colorado the sunnier and warmer it became. As we crossed the state line into Colorado it was 64 degrees and sunny. I'm counting this as a cosmic sign that we were supposed to be going home.<br /><br />We are adjusting to being home and starting a new routine. Still unpacking and sorting through the mail that has piled up. I had an electrician install a grounded outlet in the bedroom for the power module and he also put it on a dedicated circuit. The placement is perfect and allows Tyler to reach all the rooms upstairs. The "kids" were very glad to see us and of course Toby was very happy to see Tyler again. DJ stayed at the house the first night and most of Wednesday to help out. He truly has been wonderful and I still can't believe he was able to move into the house during Act I and Act II of Tyler's Heart! Unfortunately for DJ there is some separation anxiety between him and Toby.<br /><br />We met with one of the VAD Coordinators (Kathe) at University of Colorado Hospital (UCH) on Friday while having blood work done. UCH is located in Aurora which is on the east side of Denver, in a very new medical center/campus, and about 20 minutes away from our house. On January 25th we will meet with the doctors, VAD coordinators, and the transplant social workers. Tyler's results came back and his INR level is 1.5, white blood cell count good, and a bit anemic (but still in a good range).<br /><br />Friends have started coming by to "lay hands" on Tyler, bring meals, and to start getting trained on the LVAD equipment so that they can take Tyler around town without me. We also were treated to hair cuts by Orlando which was very appreciated! I was able to get my blood work and X-ray done Thursday and have a CT scan on Monday followed by my oncology appointment next Wednesday. <br /><br />So things are slowly getting to a "new normal" and now Act III starts - waiting for a heart.<br /><br />RobertRobert Denver TChttp://www.blogger.com/profile/14145497055665256073noreply@blogger.com1tag:blogger.com,1999:blog-7595060208965162331.post-37677649734046811152010-01-09T04:53:00.000-08:002010-01-09T06:28:21.913-08:00Running AwayWednesday was a long day. About 9:00am we parked at the O'Quinn tower building where Tyler has his cardio rehab and then walked over to St. Luke's to put in a request to get a copy of Tyler's medical records. As we were walking back to the O'Quinn tower we ran into a couple of Tyler's doctors who were very impressed at how well Tyler was doing and again mentioned the August conference that they are hoping Tyler can attend. Then Tyler went to his physical therapy appointment. They asked Tyler to do his "warm-up" exercises and we explained that we had just done that by walking back and forth from this building to the hospital and back. They couldn't believe we had already done that much walking and Tyler once again mentioned how mean his "at-home" nurse was to him. After his therapy appointment and meeting with a nutritionist, Julia (nurse from CV ICU) picked us up to go have lunch with her and her partner. We had a great lunch with them and then went back to the hospital to pick up the medical records. It was now about 1:45 pm. Walking through the lobby I noticed Tyler was slowing down a bit and remembered we needed to get back to the apartment soon for his afternoon meds. I asked if he would be okay if I got him a wheel chair. It took about a split second for him to agree. We got the medical records and wheeled over to the Q'Quinn building again and got home. Tyler promptly took his meds and a nap.<br /><br />Thursday the LVAD clinic called to cancel our Friday appointment due to weather. We didn't understand this at all since it would have been only our second clinic visit and the weather was just cold. The explanation was that they were still having clinic but were worried about people coming from far away. I think they looked at the records and thought we were traveling from Colorado. We pretty much demanded that we keep our appointment.<br /><br />Friday we went to our appointment with Janet and David, who gave us a lift to the hospital. As we were waiting for Dr. Kar, we were preparing for a "medical records" fight. We were under the impression that information was not being exchanged with Colorado and we were still determined to leave by January 23rd. The doctor came in and commented on how well Tyler was progressing. Still had low INR levels but it was expected and they were going to adjust the Coumadin again. He asked how Tyler's parents were doing and told Tyler to be nice to me. Then he mentioned that he understood we were both "chomping at the bit" to get home. He told us that he had been in touch with the doctor in Colorado and since things looked good we were released to go home. What?! Tyler told Dr. Kar that he wanted to respect the weekly appointments for the first four weeks. Dr. Kar said that wasn't necessary and we could go ahead and go. I'm hoping my mouth wasn't open for to long and mentally I was already on the interstate headed home.<br /><br />We discussed leaving with Janet and David. Tyler seemed to me to be hesitating and he was thinking about staying for one more clinic visit. He especially wanted to get in some more physical therapy. Janet and David mentioned that we might not want to take the chance of waiting and running into bad weather. Based on my reaction Tyler switched gears and figured we might as well leave the next day. I finally thought things through and had to many things to "deconstruct" in order to leave Houston...closing up our "winter" home and my company's "Houston office". I still can't believe I had to put in a forwarding order for our Houston address. We have decided to leave Monday morning, January 11th. We will take at least two days to drive back and have identified the heart centers along the way in Dallas, Oklahoma City, and Wichita. And yes, I promise not to drive like I'm in the movie Cannonball Run. Well, for the most part.<br /><br />I think I'm still in shock that we can go home. Could this particular chapter really be coming to a close? Are we seriously going home after almost 10 weeks? Will we have separation anxiety? How fast can we run away? Tyler even started packing after we got home.<br /><br />We have met some really great people in Houston that we will indeed miss. Houston may be the fourth largest city in the U.S., have some really crappy roads, and freaky when it comes to cold weather, but Houston also has some of the nicest people we've met. Very caring and supportive. From St. Lukes staff (nurses, doctors, social workers, admin staff, coordinators, rehab staff), other patients (especially Janet and David), the Wells Fargo banker, and neighbors at the apartments. The Houston community really has some wonderful people that helped us out tremendously. Hopefully we can visit them in August if the conference presentation of Tyler's case happens.<br /><br />But right now.....RUN AWAY....RUN AWAY!<br /><br />RobertRobert Denver TChttp://www.blogger.com/profile/14145497055665256073noreply@blogger.com1tag:blogger.com,1999:blog-7595060208965162331.post-17506594087342649702010-01-05T20:42:00.000-08:002010-01-05T21:08:09.488-08:00Progressing towards January 23rdYea, I said (wrote) it! January 23rd. We have decided we are driving back to Denver on January 23rd. Granted, we set this date on our own, but we have to leave Houston sometime. As great as St. Luke's and Houston has been to us, it is still about time for us to leave. We are both getting extremely homesick.<br /><br />It has now been two weeks out of the hospital and things are going well medically. Tyler keeps making progress and building his strength back. It has also been about 8 weeks from the open heart surgery and his chest seems to be healing well.<br /><br />Tyler had his first LVAD clinic appointment that took about three hours. While waiting on the nurses and doctors to start rounds, the clinic took on a social atmosphere as patients started visiting each others exam rooms. It confused the staff since they would show up to an empty exam room and have to find the patients in the next room. The socializing was great and the medical parts went smoothly. The doctor adjusted Tyler's Coumadin to a higher level since we are determined to eat vegetables. I know, I know....those Colorado hippies and their vegetables. As long as we have a consistent diet the doctor said they could adjust to it. <br /><br />After the clinic appointment, we went to register Tyler with the Cardio Rehab department so that Tyler has a supervised cardio therapy regimen. Of course we ran into some bureaucracy with that process but just enough to remind us that we are still in a medial system. His first workout was Tuesday and he did very well. We have gone to the apartment's fitness center a couple of times to do some light work outs and have taken a couple of walks. Tyler is able to walk faster and he is no longer using the walker. We got him a cane to use instead and he is now even getting to the point of not having to use that. He is now able to take standing showers without assistance and can stand in the kitchen to prepare meals. Good news for me! A few nights ago he experienced a lot of leg pain but the next morning was able to move his toes in his right foot, so it looks like more healing is taking place. Tyler still gets worn out but his stamina is increasing. His weight is still basically the same as when he left the hospital but we were told that is normal for the first couple of weeks.<br /><br />We had an appointment with the pain management doctor and the Fentanyl dosage was reduced again. Tyler is trying to reduce the amount of Vicadin he takes everyday and has now taken over keeping track of his daily meds and logging his LVAD stats everyday. <br /><br />We are still filing documents with the insurance companies to try and get back the money that was spent in Mexico and working on transferring care to Colorado. The University of Colorado Hospital is waiting for more medical records from St. Luke's so that they are ready for us when we get back. For some reason there appears to be hesitation by St. Luke's to send the information and we aren't sure why. I'm hoping we can keep this process moving along since, as I mentioned before, we have set a date to go home. I think 12 weeks is long enough for a vacation.<br /><br />RobertRobert Denver TChttp://www.blogger.com/profile/14145497055665256073noreply@blogger.com1tag:blogger.com,1999:blog-7595060208965162331.post-64832794089227887952009-12-29T16:58:00.000-08:002009-12-31T12:00:19.400-08:00SO MUCH TO BE THANKFUL FORWhat a week it has been - free of needles, medicines, bad food, iv's and long nights. I am so thankful to be out of the hospital after 2 long months! I am thankful that I have had Robert to stand beside me and also guide me through this difficult process. <br /><br />We have been staying in an apartment a few minutes away from all of the hospital facilities. Although a little outdated, the apartment is very comfortable and clean.<br />Physically, I am getting stronger everyday. Today, we purchased a cane, because I think in a few weeks, I will not need the walker at all. Emotionally, I remain to be pretty upbeat. Often, I get frustrated with the bureaucracy that the medical establishments make us go through, but I've only had to deal with it for a week. Robert and my parents have had to deal with it for over 2 months! I am working on just letting it go. There is nothing I can do about it.<br /><br />Again I just want to thank everyone for all they have done for Robert and I during this difficult time. You know we will bounce back, but in the mean time we are so thankful for all of the support!Robert Denver TChttp://www.blogger.com/profile/14145497055665256073noreply@blogger.com2tag:blogger.com,1999:blog-7595060208965162331.post-29446891460013161492009-12-28T19:42:00.000-08:002009-12-29T07:01:17.650-08:00New Routine & WaitingIt has been 6 days since Tyler left the hospital. No alarms, no scares. Maybe one scare when Tyler hit the self-test button by accident in the middle of the night and all the alarms started testing. Neither of us panicked. I got up to check but before I got there Tyler had already figured out what had happened. We both went right back to sleep. Okay, maybe a few more scares when 6am, 9am, 2pm, 5pm, or 10pm comes around and the realization hits that medicine needs to be taken.<br /><br />We went in for blood work Monday and there is a problem with his INR ratio which measures the coagulation properties of his blood. It is at 1.4 and I believe they would like it to be around 2.0. When he was still at the hospital it went down to 1.6 and they gave him a blood transfusion of about 2.5 pints. We don't want to do that again. Tyler was asked if he had been eating salads over the past couple of days. That is when we became aware that we shouldn't have been eating foods high in Vitamin K, like green vegetables, as it reacts to the Coumadin (blood thinner) medication. I say "aware" because we may have been told during the rush of information and forgot. So, no eating the good stuff anymore, like vegetables. We've looked up stuff high in Vitamin K and will be avoiding these.<br /><br />We took a 40 minute walk outside of the apartment Sunday since it was a nice sunny day in the upper 60s. I guess doing the initial recovery in Houston isn't such a bad thing after all. Could be in Denver with snow and temperatures in just the 20s. Tyler is walking further and a little faster and better. <br /><br />Wednesday we go to "clinic" which is the LVAD clinic appointment we will have every week. This is to make sure things still look good. Next week cardiac therapy begins.<br /><br />I have run Tyler around on errands and he tends to get a bit car sick. I'm sure it has everything to do with the medicine and nothing to do with my driving.<br /><br />We are trying to adjust to a new routine. Morning is made up of taking pills at 6am (then more sleep), then logging vitals like weight and temperature. Also running self-tests on the system controller and power module. Then trying to figure out the best way for Tyler to take a shower. Then the dressing change. Then pills at 9am. Figuring out what needs to be done that day....grocery store, set up doctor's appointments, PT exercises, Robert's work, dealing with Social Security forms, and more. Each day we get a little better at the new routine that will be with us until the heart transplant (which will then bring another different routine). <br /><br />We are also now in a waiting period. Waiting to see if things go well during the next few weeks. Waiting to see if the transfer of care to Colorado will happen. Waiting to see when we can pack up the car and move to Denver. Hoping that we don't get too grouchy with each other.<br /><br />But hopefully the days will become more routine even if it is still a weird. <br /><br />RobertRobert Denver TChttp://www.blogger.com/profile/14145497055665256073noreply@blogger.com1tag:blogger.com,1999:blog-7595060208965162331.post-71998186394375858362009-12-26T05:46:00.001-08:002009-12-26T07:52:01.755-08:00Halfway HouseTyler was discharged by the doctor from the hospital about 9:30am Wednesday.<br />We left about 12:30pm once all the paperwork was done and transportation (the hospital wheelchair ride) came to get Tyler. We almost got into trouble after packing up our stuff and just trying to leave. We just desperately wanted to get out of the hospital after 8 weeks of being there. Once we got to the main lobby I was asked to go get the car (from the garage) and then I could pick up Tyler. I had to explain that since the transport person wasn't trained with LVADs, Tyler had to stay with me. So Tyler and I walked to the garage again to get the car. We pulled up to the front entrance to get our stuff including the LVAD equipment (battery charger and power module). The transport person had left so I just went in and grabbed the wheelchair cart. Another person then started accosting me about "where is the patient?" I was loosing my temper and just said "in the car!" and continued to roll our stuff out. She was obviously freaked out a bit since this is not hospital policy and kept following me asking "where is the patient". I finally stopped and explained again that I can't leave the "patient" and that he was IN...THE...CAR. I was basically saying..."LEAVE ME ALONE". Felt almost like a prison break. <br /><br />Before we left Tyler's hospital room, the doctor and social worker both commented that they had been in touch with the University of Colorado Hospital and were exchanging information. The doctor mentioned that we should be able to do about 4-5 clinic visits in Houston and if all went well should be able to transfer care and transplant lists, and finally get home. That would put us moving back home at the beginning of February 2010. At that time Tyler would have been away from the house for almost 3 1/2 months.<br /><br />We then proceeded to get some lunch and go to the pharmacy to fill his prescriptions. We waited about an hour and a half at the pharmacy to get 14 prescriptions filled. This was cutting it close since Tyler needed to take two of the prescriptions right away. Once we finished at the pharmacy we went back to the apartment to unload everything we brought from the hospital. Then we went to the grocery store. Tyler had to stop a couple of times and rest at the grocery store while I was finishing up.<br /><br />We then had to figure out how to make sure we were dispensing the right medicines at the right times, how to sleep (since Tyler can only sleep on his back or left side), and how to take a shower with all the LVAD equipment since it can't get wet.<br /><br />While it is good to be out of the hospital and in our "halfway house", we now are adapting to another "chapter" of this experience. We will miss the nurses, PCA's, and staff a lot! As the days go by we are figuring out how to deal with everything step by step. It is amazing how the "little" things have become "big" things now. Just going to the grocery store takes a lot of thought and preparation.<br /><br />The days in Houston will become "normal". Logging all the medicines taken and equipment settings, doing physical therapy exercises, and running errands. Janet brought over treats Thursday night and we took over Tyler's spaghetti sauce Friday night. Tyler was able to ascend the stairs to Janet's apartment, although slowly, but is still making progress walking around. I also called Mitzy Friday night and she has been able to go back to her house north of Houston. Her husband, Ben, was moved to a clinic near their house on Tuesday. Interesting that Mitzy and I arrived at St. Luke's the same night and for almost the same exact duration. <br /><br />I have posted two links about the LVAD so people can get a glimpse of what it looks like and a video of a woman living with the LVAD.<br /><a OnClick="window.open('http://www.youtube.com/watch?v=-Q2wyRwqboY')"><u>Living with an LVAD</u></a><br /><a OnClick="window.open('http://www.youtube.com/watch?v=GkSC0J--PBc')"><u>HeartMate II Video Clip</u></a><br /><br />Now we hopefully can have successful clinic visits and start looking towards getting home. We are trying to determine if we are going to drive or fly home. Flying would be faster and would get us from big city to big city. But we would have to carry his LVAD equipment onto the plane and that will become a hassle. Also, we currently have Tyler's car in Houston and would have to figure out how to get that back to Denver so we would also have it there. Driving is simpler logistically, but means 20 hours (split over two or more days) through not the most populated areas of the county. I figure we made it from Cozumel to Houston unexpectedly so we should be able to deal with the unexpected. <br /><br />RobertRobert Denver TChttp://www.blogger.com/profile/14145497055665256073noreply@blogger.com1tag:blogger.com,1999:blog-7595060208965162331.post-35362133752420000962009-12-23T04:21:00.000-08:002009-12-23T05:44:35.499-08:00I'll be home for Christmas - kindaTyler is still experiencing a sharp electrical type pain in his right leg but is able to move his foot more. He is using a cane or walker to move around but at least he is mobile. He continues to cut back on the pain medicine, but still gets waves of nausea every now and then.<br /><br />I got back to Houston and went directly to the hospital since Tyler was holding the apartment keys hostage. Thank goodness because I had forgotten why I was in Houston. When I got to the hospital Tyler was having an echo-cardiogram done by order of Dr. Frasier. Dr. Frasier came in and adjusted Tyler's pump to see the effect while viewing the echo. He settled on 9400 RPM and again made a comment about maybe Tyler's heart could get some R&R and Tyler wouldn't need a transplant. Tyler thinks he can wrap his head around that. I think I can also!<br /><br />After adjusting the pump and the echo, Tyler and I were going to go to dinner outside of the hospital. Before we could go, it dawned on me that they only adjusted the primary controller to 9400 and not the backup controller. So we waited for just a little bit to get that fixed. Dinner was good. Table with chairs for both of us. No candlelight, but a waiter. Salad came out first, then the main meal. A pleasant, non-hospital smell...could there be life outside of the hospital?<br /><br />A special thanks to his mom and sister for staying with Tyler. They didn't necessarily come to Houston just so I could take a trip back to Denver...I think they may have wanted to see Tyler also. It was good to have the chance to go back to Denver and to come back to a cleaner apartment! They also left a really nice card for us. Weird circumstances but it has been good to really get to know them. They have been wonderful to me. <br /><br />Tuesday was our 8 hour pass day. In the morning we asked about a handicap sticker for the car. The reaction was negative at first...."the doctor doesn't really like to issue handicap stickers....." Okay, okay. Can anyone look at more than just the top or bottom half of Tyler. Can anyone notice the walker, cane, and wheelchair in the room? Ay dios mio!<br />Also, a different doctor came in who didn't know about the Fentanyl patch Tyler is wearing. Once he looked, he noticed it was a 50mg patch and said that Tyler was going to have to be weened off of it. Tyler said "fine, as long as I don't have to stay in the hospital during the weening process." Otherwise I think he was just going to pull it off and say goodbye. <br /><br />Tyler used his walker to go from his hospital room, all the way through the hospital, and through the garage to the car. It is a long walk but he did fine. Only once, stepping off a curb, did his left knee give him trouble. We went to the apartment and had lunch. Then watched a little bit of a movie before Tyler got tired and wanted to take a nap. After the nap we went to get him a hair cut, which he thoroughly enjoyed (especially getting his hair washed for real after two months). Finally something normal and usually inconsequential but yet another big step in recovery. After the hair-cut we went back to the apartment and hung out until about 7pm. Janet brought over some cookies and both of them gave me grief since Tyler had to get up and answer the door for her. I just considered that occupational therapy.....right?<br /><br />Once we got back to the hospital the nurse tried to give him a 50mg Fentanyl patch, even though he was supposed to be weening off of Fentanyl. Both of us protested and finally they were able to bring him a 25mg patch.<br /><br />Now the next big step (Christmas miracle?) is actually discharging him from the hospital, which we are doing today. I'm glad because I won't have to run back and forth to the hospital. Tyler, for some reason, is chomping at the bit to get out. We aren't home yet, but a least out of the hospital. Can anyone really believe it has been 8 1/2 weeks? So long, yet so fast. Maybe October 25, 2009 will finally be over soon! (Soon being a relative term these days).<br /><br />RobertRobert Denver TChttp://www.blogger.com/profile/14145497055665256073noreply@blogger.com2tag:blogger.com,1999:blog-7595060208965162331.post-1234963166188950972009-12-20T08:52:00.000-08:002009-12-20T11:03:26.522-08:00"ITS MY TURN"In response to the most recent posting...if my partner would have given me access to the passwords(he's become a little more controlling these days)then maybe I would have had an opportunity to write more(but I guess this blog is his "baby" - and me relinquishing some control could be a good thing). Also, I am somewhat intimidated by his ability to write creatively - since everyone seems so impressed by his writing style.<br /><br />As you all know, I will be able to get out of the hospital on Wednesday and then Robert and I get to enjoy our Houston apartment together for 5 weeks(can't wait to be in a home). Although Robert says 1-2 months, I am going to be adamant about 5 weeks - because being out of the hospital is nice, but being in our own home in Denver will be much better! Although it's been a really long haul staying in the hospital for this long, I couldn't have asked for a more amazing nursing staff...God definitely brought me to the best place and I'm going to miss them (not too much though). <br /><br />I also wanted to send out a big "Thank-you" to anyone and everyone who had anything to do with the fundraiser held at Rock Bottom - I was overwhelmed by the out-pouring of love and generosity from all of our friends. Truly, a "thank-you" will never be enough! <br />Cheers for now,<br /><br />TylerRobert Denver TChttp://www.blogger.com/profile/14145497055665256073noreply@blogger.com2